<fieldset>
<legend><?php echo JText::_('Pick Up Notices Parrams')?></legend>
	<table>
		<tr>
			<td><?php echo '{line-break}' ;?></td>
			<td width='10'>:</td>
			<td>Line break</td>
		</tr>
		<tr>
			<td><?php echo JText::_('{f_name}') ;?></td>
			<td width='10'>:</td>
			<td>First name</td>
		</tr>
		<tr>
			<td><?php echo JText::_('{l_name}') ;?></td>
			<td width='10'>:</td>
			<td>Last name</td>
		</tr>
		<tr>
			<td><?php echo JText::_('{name_on_card}') ;?></td>
			<td width='10'>:</td>
			<td>Name as of appears on card</td>
		</tr>
		<tr>
			<td><?php echo JText::_('{member_id}') ;?></td>
			<td width='10'>:</td>
			<td>VIPCard number</td>
		</tr>
		<tr>
			<td><?php echo JText::_('{outlet_name}') ;?></td>
			<td width='10'>:</td>
			<td>Pick up outlet</td>
		</tr>
		<tr>
			<td><?php echo JText::_('{outlet_address}') ;?></td>
			<td width='10'>:</td>
			<td>Outlet address</td>
		</tr>
	</table>
</fieldset>